<link href="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/js/bootstrap.min.js"></script> <script src="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> <!------ Include the above in your HEAD tag ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>Outcome Assessment (evoked pain-related behavior)</legend> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">What behavioural assessment(s) are used?</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">von Frey filament (manuel)</option> <option value="2">von Frey filament (electronic)</option> <option value="">Randall-Seiltto (pressur)</option> <option value="">PinPrick</option> <option value="">Hargreave´s test</option> <option value="">Hot plate</option> <option value="">Tail flick test (Radiant heat)</option> <option value="">Cold plate</option> <option value="">Acetone evaporation test</option> <option value="">Catwalk</option> <option value="">Digigait</option> <option value="">Other</option> </select> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea">Optional Comments</label> <div class="col-md-4"> <textarea class="form-control" id="textarea" name="textarea">Paste the exact device description from the pdf</textarea> </div> </div> <!-- Search input--> <div class="form-group"> <label class="col-md-4 control-label" for="searchinput">What was the habituation time prior to the test?</label> <div class="col-md-4"> <input id="searchinput" name="searchinput" type="search" placeholder="min" class="form-control input-md"> <p class="help-block">Give in min</p> </div> </div> <!-- Textarea --> <div class="form-group"> <label class="col-md-4 control-label" for="textarea">Optional Comments</label> <div class="col-md-4"> <textarea class="form-control" id="textarea" name="textarea">Comments</textarea> </div> </div> <!-- Search input--> <div class="form-group"> <label class="col-md-4 control-label" for="searchinput">How large were the animal boxes?</label> <div class="col-md-4"> <input id="searchinput" name="searchinput" type="search" placeholder="Length x Width x Height" class="form-control input-md"> <p class="help-block">in cm</p> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">Outcome measure average type</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">Mean</option> <option value="2">Median</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">Outcome measure error type</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">SD</option> <option value="2">SEM</option> <option value="">IQR</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">Outcome measure units</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">gramm</option> <option value="2">force</option> <option value="">latency time</option> <option value="">oberservation period</option> <option value="">score</option> <option value="">ratio</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">What is the stimulus called?</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">Painful</option> <option value="2">Noxious</option> <option value="">Nociceptive</option> <option value="">Suprathreshold</option> <option value="">Highthreshold</option> <option value="">Pricking</option> <option value="">Not reported</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="selectbasic">What pain symptom was measured with the stimulus?</label> <div class="col-md-4"> <select id="selectbasic" name="selectbasic" class="form-control"> <option value="1">Mechanical hyperalgesia</option> <option value="2">Mechanical allodynia</option> <option value="">Mechanical hypersensivity</option> <option value="">Heat hyperalgesia</option> <option value="">Heat allodynia</option> <option value="">Heat hypersensivity</option> <option value="">Cold hyperalgesia</option> <option value="">Cold allodynia</option> <option value="">Cold hypersensivity</option> <option value="">Antalgic gait</option> </select> </div> </div> </fieldset> </form>